Gallium-68 Citrate PET/CT for Diagnosis and Treatment Response Assessment of Infections-Prospective Study.
Hanna Elizabeth Johnson, Saumya Sara Sunny, David Mathew, Regi Oommen, Nylla Shanthly, Priscilla Rupali, Regi Thomas, Rajan Sundaresan, Sumant Samuel, Anil Oommen, Venkatesh Krishnan, Julie Hephzibah
Abstract
Open AccessObjective: This article aims to assess the presence of skeletal and soft tissue infections before or after treatment and to assess treatment response in Ga-68 citrate positron emission tomography/computed tomography (PET/CT) scan positive patients. Materials and Methods: A prospective study was conducted for 43 patients. The eligibility criteria included those patients clinically suspected of infections who underwent a Ga-68 citrate PET/CT. Exclusion criteria were pregnancy and lactation. Patients with suspicion of infection or treatment failure underwent a Ga-68 citrate PET/CT between January 2020 and November 2021. Among these, eight patients underwent a follow-up scan posttreatment to assess their treatment response. The Institutional Review Board (IRB No.12511) approved the study. Results: Forty-three patients underwent a diagnostic Ga-68 citrate PET/CT scan. The scan interpretation was based on visual comparison of uptake of Ga-68 citrate in the region of interest, which was compared with the normal side/adjacent soft tissue/blood pool. The semiquantitative parameter maximum standardized uptake value was retrospectively analyzed as well. PET/CT findings were correlated with tissue diagnosis, clinical symptoms, biochemical parameters like C-reactive protein (CRP), erythrocyte sedimentation rate, and total leukocyte count, and other imaging modalities with a statistically significant association with CRP ( p = 0.001). Tissue diagnosis was considered the gold standard and out of the 43 patients included in the study, 27 had a tissue diagnosis. Sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were calculated at 100, 87.5, 100, 95, and 96.3%, respectively. Conclusion: Ga-68 citrate is a promising tool to assess the presence of bone and soft tissue infections before or after treatment.